**How to choose a Plastic Surgeon. *

There is a lot of public confusion about who is qualified to perform cosmetic surgery.

The decision to undergo cosmetic surgery is an important one and should not be taken lightly.  In the right hands, it can result in a wonderful positive enhancement; however, in the wrong hands, it could result in a regrettable situation.  

The following guidelines are general considerations that will help you find the right surgeon. The basic things to look for when starting your search are the following:

1)Board Certification
2)Hospital Privileges
3)A shared philosophy
4)Opportunity to meet or talk to past patients.
5)Specialization

*1) Board Certification: what does it mean? *

The goal of board certification is to increase public safety by insuring that physicians within a specific specialty have been trained appropriately and have met specific standards of competence. Although board certification, in and of itself, it does not imply or guarantee an excellent outcome, it does mean that the individual you are considering for your plastic surgery procedure has had and met a certain high level of training requirements. This means that they have completed a residency and passed examinations. It does not, however, guarantee skill, artistry, or excellent outcomes.  

_The American Board of Medical Specialties (ABMS)
_

The ABMS (American Board of Medical Specialties) is the main governing board that defines scope of practice for each specialty.  It defines what services each specialty is “officially allowed” to offer patients.  

When it comes to plastic surgery there are technically 3 specialties that are qualified to offer cosmetic and reconstructive surgical procedures.  Each of these specialty areas has a specific scope of practice that is defined by the ABMS.  

Who is qualified by the ABMS?

Above the shoulders:

When it comes to plastic surgery within the region of the head and neck (eyes, face, nose, neck), the following specialties are qualified by the ABMS:

1) Otolaryngology-Head and Neck Surgery/ Facial Plastic and Reconstructive Surgery.
Members of this specialty complete 1 year of General Surgery, followed by a 4-5 year residency in Head and Neck surgery (which includes Facial Plastic Surgery).   Those interested in focusing on cosmetic and reconstructive surgery of the face and neck, then go on to complete a Fellowship in Facial Plastic and Reconstructive Surgery offered by the American Academy of Facial Plastic and Reconstructive Surgery. This prestigious and competitive Fellowship is offered to 40 individuals each year.  The "Fellow" spends one year concentrating on cosmetic and reconstructive facial surgery under a recognized leader in the field.  

Following this Fellowship, the individual must sit for yet another rigorous written and oral examination followed by submission of operative cases over a 2-year period.  This qualifies the surgeon to be recognized as Board Certified in Facial Plastic and Reconstructive Surgery.   Hence, the individual will be double board certified.  

This specialty focuses on the plastic surgery of the face, nose, eyes and neck.  

A total 6 years of surgical training is required for training. *

2) Plastic and Reconstructive Surgery
Members of this specialty complete 3-5 years of General Surgery, followed by 2-3 year residency in Plastic and Reconstructive Surgery.  During the 2-3 year residency, the surgeon is exposed to plastic surgical procedures throughout the body including the face.  Surgeon interested in a specific part of the body will go on to complete a Fellowship.

*A total of 5-7 years of surgical training is required. *

3) Ophthalmology/ Oculoplastic Surgery

Members of this specialty are trained to perform a range of reconstructive, functional, and cosmetic procedures of the eye.  They complete a residency in Ophthalmology followed by a Fellowship in Oculoplastic Surgery.  

The oculoplastic surgeon treats the eye and the region around the eye.  

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Below the Neck:  

For everything below the clavicles- breast, body, abdomen etc, there is only one specialty that is recognized by the ABMS and that is Plastic and Reconstructive Surgery.

That is why you may have heard the line, go to a surgeon who is Board Certified by the American Board of Plastic and Reconstructive Surgery.  

This applies specifically to the work done on the body.  

*
2)Hospital Privileges: a must*

Anyone can perform procedures out of their office, but only a qualified specialist can do it out of a hospital or an accredited outpatient surgery center.  Without the proper credentials, the individual will not get privileges.  So this is a easy way to determine an individuals credentials.  

So if you are considering a breast augmentation or facelift for example, make sure your surgeon has privileges to perform these surgeries at a hospital.  

Also, in case of a complication, you want to make sure the surgeon who operated on you would be able to handle the problem at a hospital if needed.  

*3)A shared philosophy:  the need to see eye to eye. *

You and your surgeon need to be on the same page.   This is a prerequisite to a successful outcome.  It is as simple as that.  Your surgeon needs to capture your expectations, concerns and hopes.  Without this, the surgery could miss the mark and you will be left feeling unsatisfied.   This is the #1 reason for revision surgery.  

Remember, board certification and Ivy League schools are not indicators of your Surgeon's artistic sense and judgment.  What differentiates excellent Plastic Surgeons from good Plastic Surgeons cannot be taught, it is innate.  

 Looking at before and after photos, or meeting individuals that have had the procedure will give you a glimpse into the craftsmanship and quality of results.   Remember, excellent plastic surgery doesn't look unnatural or "plastic."  It should simply enhance your intrinsic beauty.   Although most surgeons will display their best photos, if the surgeon has done lots of surgery, they will have plenty of examples for you to look at.  Don't be afraid to ask to see them.  

4)Opportunity to meet or talk to past patients.

This is perhaps one of the best ways to learn about your surgeon.  Ask to speak to the last 3-4 patients he/she has operated on.  This may provide insight into how the surgeon treats their patients, the way they handle issues that may come up, and ultimately how happy or unhappy the person is with their result.  This can provide a great deal of insight.

The surgeon should be happy to provide you with a list of individuals who have had similar procedures.  

5)Specialization

You want to find a surgeon that focuses on the type of surgery you are considering.  Specialization increases your chances for a successful outcome because the surgeon has the experience it takes to achieve great results on a consistent bases.  For example, if you are considering cosmetic surgery, it is important that you find a surgeon that specializes in cosmetic surgery.  A surgeon that performs 80% reconstructive surgery may not have the same level of experience to achieve consistently excellent results.  

Moreover, certain procedures, such as rhinoplasty and facelifts require a higher level of skill and expertise to achieve the right outcomes.  So, spend the time to find a doctor that meets these basic requirements.  Another important factor is, don't let money or cost determine whom you go to.  Cost (high or low) is not always an indicator of outcome.  However, if you really like a doctor and their cost is higher than you can afford, it is better to wait and do it with the qualified surgeon than compromise and get it done with a less expensive doctor.   In the end it’s your body and you deserve the best.

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